To let you know that you're not doing yourself any favours by refusing to tell the GP receptionist your symptoms?

[privateeyefan]

I'm a GP. My surgery operate a triage system - if you ring up or walk in asking for an appointment, then you get put on the triage list, and get a phone call from the doctor that same day, who can then make an appointment for you if you need one.

When patients ring up or walk in, the receptionists who speak to them will ask for a brief outline of the problem. This means that, as we usually have at least 3 doctors doing triage at any one time, we can prioritise the calls - if if see things that I know will need an appointment, then I will call those patients first so that I can get them into the surgery on the same day, often within the hour.

If you refuse to tell the receptionist what the problem is, and there is therefore nothing next to your name on the triage list, then I leave you until last. I'm not going to prioritise you over people I know will have to be seen, when I have no idea whether or not you will need an appointment. Therefore, if you don't tell the receptionist, your chances of a same-day appointment decrease substantially, and you will also have last choice of appointments over the next few days - the most convenient times after working hours will be long gone.

In addition, I, like most of my colleagues, have a special interest in a certain field. As I glance through the triage list, I generally pick out patients whose problem relates to my particular field of expertise, as do my colleagues. By refusing to give even the briefest of outlines, you rule out the chance that the GP with the most relevant experience will contact you directly.

Receptionists don't have medical training. Of course not. But that doesn't make them incapable of typing a one line summary of your problem dictated by you, in order to help the doctors do their job.

And please also remember - they speak to hundreds of patients daily. Your problem will occupy their mind for a few seconds, and then they will move on to the next patient and you will be swiftly forgotten.

'I've got shingles on my vulva and bottom atm. I'm not going to stand in a queue and tell a receptionist my vulva is massively swollen and has split open. I wouldn't stand in a queue with my DB and tell the receptionist he is having paranoid delusions or hearing voices. '

You don't have to say 'my vulva has split open' or 'my brother had paranoid delusions.' Just say 'I have shingles' or 'my brother has a mental health problem that needs urgent attention'

I really don't like the sound of your triage system - I'm another one who simply cannot take calls as and when I feel like it. It isn't exactly the patients fault there aren't enough routine appointments available. Also, putting the people who value privacy to the bottom of the list isn't triage. And could (presumably) get you in to trouble if a "no reason given" person was actually very ill waiting for callback or had a mental health crisis. Surely the list is a) things which are likely to be urgent, b) unknown, c)things which a likely to be routine.

All that said, what is out of hours like in your area? It's nigh on impossible to get a Monday urgent appointment (like I needed) because out of hours is so bad at the weekend that anyone who possibly can waits til the doctors open on Monday. I'm totally convinced that if out of hours was sorted properly the pressures on A&E and GPs would be massively reduced, as would outcomes for patients. I have no actual evidence for this except my own experience - waited too long to get antibiotics for tonsillitis and ended up needing A&E HDU, IV antibiotics and painkillers, CT scan, surgery and a 3 night stay in hospital. Decent ooh must be way cheaper overall.

I know Dr's & Receptionists have heard it all but I can never get thru on the phone so I go in on the way home from work if I need an appt: & I don't want to broadcast I'm feeling suicidal or my thrush is back (how else would you say it) to a queue that's aleays 6deep. Privacy & confidentiality matter, especially to the older generation. Someone may be critically unwell but too embarrassed to describe intimate symptoms.

Well I think if you're feeling bad, you'll do what's necessary to get yourself sorted out.

People aren't necessarily feeling bad though. If you can't book even a routine appointment without speaking to a Dr first there will be lots of patients trying to manage chronic conditions who need routine check ups.

Yet every time they need to book one they have to go through this process. What if you cannot take personal calls whilst at work? How do you make an appointment?

There's a thread running currently. A teacher is receiving treatment for MS yet their boss is saying they've taken too much time off to attend appointments. Imagine how much worse it would be if they also had to take time off just to phone their GP to make a routine appointment?

As a Dr I'm a bit concerned about your level of empathy for patients with potentially embarrassing or upsetting problems. Your showing quite an unpleasant attitude to people who will be worried and embarrassed

I'm only on page 4 but I absolutely agree with this.

The system described sounds unhelpful, unfriendly and inefficient. OP seems to have no understanding that patients will not want discussion of their symptoms being overheard.

How does this call back system work ? Once I told your receptionist and anyone else who might be in earshot am I then expected to go home and sit by the phone until you call me back? What if the appointment time offered doesn't suit?

cannot abide people having a sulk at being asked what their symptoms are by a receptionist. They're clearly not asking so thet can have a giggle at you, it is all in your best interest

Whoever posted this are you so dim that you don't realise why people will not want to have whoever might be in the waiting room hearing about their symptoms?

I have a massive problem with this. There is no need to tell a receptionist my health issues. It’s a confidentiality issue. Sometimes they ask you to repeat your name, all with a packed waiting room listen and then you have to tell them what it’s about. It’s outrageous but clearly GPs like it because it saves them time.

Forgot to say: the triage system is so easily abused by the cf or streetwise. My work colleague's Dr does triage , so she routinely says her child 'has a high temp & is floppy' as she's realised that gets her a same day appointment . I said the Dr would notice that her child wasn't presenting those symptoms once there, but she said 'well kids can change by the minute when they're ill & no ones questioned it'.

Forgot to say: the triage system is so easily abused by the cf or streetwise. My work colleague's Dr does triage , so she routinely says her child 'has a high temp & is floppy' as she's realised that gets her a same day appointment

Good point. Probably especially likely to happen if patients resent a stupid booking system.

@privateeyefan are you going to respond to any of the posters where explaining symptoms to a receptionist hasn’t worked out? Or are you going to keep repeating what happens at your surgery? You do realise that the chance of any of us being your patient is very small, therefore your anecdotes about how wonderful your system is are largely irrelevant?

Halo1234

I just re-read original post. She/he did say that if a patient has a condition that is within their area of expertise they are more likely to phone them sooner/first.

I can see any part of the OP that says that? She talks about prioritising based on need.

In a separate paragraph she says they identify patients with issues within particular doctor's areas of expertise. She doesn't say they get phoned sooner - just that they get phoned / seen by relevant doctor

I'm still wondering how helpful this system is.

I know the intention is that you only give a brief overview / mention the area. But without some detail, how can OP know how to prioritise?

To have to give that necessary detail, does put the patient in an uncomfortable situation & also requires a level of interpretation from the receptionist - they need to note accurately what's being said & understand why it's significant, so may need to ask more questions & then that's outside their remit.

I do, however, think all the posts asking OP why she hasn't responded to their practice's system of triage, are unfair.

In fairness, all OP can do is explain her own system & why she does think it works.

Ime of working with people the REAL issue is the one they blurt out as you are saying your goodbyes and about to walk out the door. Usually due to shame or embarrassment or their belief that it deserves shame and embarrassment.
So this system wouldn't work for them.

Also discussing your anxiety due to traumatising familial sex abuse events with randoms in the surgery is not on.

I think the OP has chosen the wrong career.

Then maybe there should be a tad more privacy given if people are expected to divulge their issues to someone not trained in any health care? It all well saying give over your intimate details to a receptionist, and then we'll work out who we will phone, but many people have poor experiences with reception staff and lack of confidentiality, expectation of too many details being expected. There is a fine line between the two I feel.

I do, however, think all the posts asking OP why she hasn't responded to their practice's system of triage, are unfair.

But given the thread title and the nature of the OP, isn’t it inevitable?

QueenBeee

Ime of working with people the REAL issue is the one they blurt out as you are saying your goodbyes and about to walk out the door. Usually due to shame or embarrassment or their belief that it deserves shame and embarrassment.

this is a really good point

Butchy I know what you mean, but all OP can do is explain her system, where receptionists dong triage. She is saying she doesn't support the practices where this does happen.

It’s their attitudes that get most people’s backs up I think. It would appear only the grumpiest, most sour faced ladies (usually) fit the criteria for GP receptionist.

If they nicely said ‘are you able to tell me what the problem is so I can pass this along the doctor who will call you back’ people might be more open to it rather than ‘and why do you need an appointment’.

I understand you’ll probably reply saying the ones at your surgery are ever so sweet and lovely but on the whole ... especially going by the multiple threads on here in the past ... they aren’t.

So glad my Dr doesn't operate this system. We have to phone up at 8am on the dot to get a same-day appointment. It does mean calling 20-40 times to get through but if you sit there for 5 mins and keep hitting redial it take 5 mins of your life. I know what specialisms my drs have ( it takes 2 mins to Google) and I request specific drs if required. I feel very lucky having read through some of your stories on here!

I've had to tell the receptionist more than once that it's not appropriate to boom out as if she is a human megaphone, the condition or medication in our open plan reception area before. 'Oh, so your prescription for XYZ (penis cream/vaginal discharge situation/STD/anything else a patient might be suffering with) should be at the pharmacy already'.....or .....'so Dr ABC wanted you to rebook for a followup on your extremely private and possibly embarrasing condition.....' really is pretty unprofesional and a really big reason for not wanting to disclose to a random person behind the desk. Also, the receptionist is, I believe, not bound by the confidentiality requirements that a Dr is. Sort that out and perhaps your patients would be more willing to be open.

Great post! Could never understand why people are against talking to the receptionists, been at my surgery 30 yrs, dont do very often but they are great, helpful, sympathetic and can initially direct you as whether you need a gp or nurse. If its private you say so and mine will take you to one side, I once had a conversation in a corridor re a problem with my lady bits! Receptionist are the unsung heroes.

It totally depends on the receptionists TBH. They've introduced this system to our surgery. And the receptionist was rude and didn't actually type down my symptoms. Which was a problem. This receptionist also 'has no truck with MH issues'. Not great really.

Perhaps if GPs surgeries make sure they have appropriate training for reception staff - and disciplinary action if they are shown to disadvantage patients due to disability, then patients may be more inclined to play ball?

Very well said @SD1978

The fundamental purpose of what OP wants us to accept is a system that enables the GP to see fewer patients. This is wholly at odds with what many many patients want, which is more access to doctors. This is at the heart of why people are struggling with it.

Mumsnet isn't going to give a clear answer either. Everyone here is tech savvy etc so we are not the people who won't sign up.fo online system etc. The problem is that all the people who struggle with this triage type system are also likely to be the people with complex/chronic/recurring health needs, who are the heaviest users of the health care service.

Eg very elderly people comprise the majority of the waiting room every time I go to my GP. Many of these people are set in their ways & you are not going to effectively reduce them expecting to see a GP for every little thing, without pissing them off a lot. That is probably why they are taking it out on your receptionists, who are then leaving. It's a demographic problem and it's clearly worse in some areas.

I'd like to see specialised geriatric medicine practises which are set up to understand the needs of elderly heavy users of GP practises and reduce the extent to which they clog up the system for everyone else.

You're lucky @Jayaywhynot - many reception staff are not very professional.